Electronic Cigarettes: Are they effective?

The Drugs and Addictions Research Group in the School of Psychology have just published their first ‘electronic cigarette’ study. 

These battery-operated devices are designed to resemble cigarette smoking by delivering nicotine via inhaled vapour without containing the harmful tars and carbon monoxide associated with tobacco smoking.  Whilst the World Health Organization have banned companies  making claims about their therapeutic success, most users state that they use the device to quit smoking. 

So are they effective?  We do not know yet whether the electronic cigarette (e-cigarette) provides a effective means of quitting as randomized controlled trials (RCTs) have not yet been completed (there is one underway in New Zealand).   Our study suggests however, that it can help to alleviate withdrawal symptoms and craving after a short period of deprivation.  We asked 86 participants to remain abstinent from smoking for a least one hour and rate their withdrawal symptom and craving before, and 20 minutes after, using an electronic cigarette for 5 minutes.  Although all e-cigarettes were tobacco flavoured, some contained nicotine and some didn’t (placebo).  For comparison purposes, a further group of participants just held the e-cigarette but didn’t use it. 

Compared to this ‘just hold’ group, those using the e-cigarette reported a significant reduction in craving and withdrawal symptoms.  For males, the nicotine e-cigarette was superior to placebo whilst females did just as well with the placebo.  Unlike other forms of nicotine replacement therapy (e.g. patch and gum), the e-cigarette delivers nicotine AND resembles the act of smoking thus providing the user with the ‘hand-mouth’ activity associated with tobacco smoking.  It is becoming increasingly recognized that these sensorimotor aspects of smoking may be an important aspect of smoking behaviour and our findings suggest that this might be more relevant for females. 

We also included a memory test in our study (remembering three letters whilst performing a distractor task which increased in length over consecutive trials).  Previous research has shown that memory and attention is worse during abstinence from smoking and can be restored after smoking a cigarette.  Participants who received the nicotine e-cigarette in this study did much better on this task compared to those who received placebo or who just held the e-cigarette.  This was particularly apparent at the longer interference intervals. 

Together, these findings suggest that the electronic cigarette has great potential as a quit smoking aid given that it can alleviate craving, withdrawal symptoms and the mild cognitive impairment associated with smoking deprivation.  Whether the placebo  is just as effective as the nicotine e-cigarette for female quitters is an interesting question which will remain unanswered until RCTs have been completed. 

Full article reference:  Dawkins, L., Turner, J., Hasna, S. & Soar, K. (2012)  The electronic-cigarette: Effects on desire to smoke, withdrawal symptoms and cognition.  Addictive Behaviors, 37: 970-973.

Or visit ROAR:  http://hdl.handle.net/10552/1568

Lynne